title: Primary and Reversible Pisa Syndrome in Juvenile Normal Pressure Hydrocephalus.
abstract: OBJECTIVE
  To report a case of Pisa syndrome in a patient with idiopathic normal pressure hydrocephalus, who had never been exposed to psychotropic medications.
  
  
  METHODS
  A 26 years-old, Colombian, male patient, was referred because he had cognitive abnormalities, gait disturbances and urinary incontinence. This patient also displayed pleurothotonos. Neurofunctional evaluation of sensory and motor integration at peripheral and central nervous system levels were done.
  
  
  RESULTS
  Pisa syndrome disappeared after spinal tap drainage with further gait, balance and behavioral improvement. A brainstem-thalamocortical deregulation of the central sensory and motor programming, due to the chaotic enlargement of brain ventricles was thought to be the pathophysiological mechanism underlying this case.
  
  
  CONCLUSIONS
  NPH must not be longer considered as an exclusive geriatric disorder. Further, uncommon movement disorders may appear with this disorder, which should be carefully approached to avoid iatrogenic and deleterious pharmacological interventions.
authors.affiliation: Smell and Taste Center, University of Pennsylvania, PA, USA ; Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, PA, USA ; Unit of Parkinson and Movement Disorders, Mediciencias Research Group; Professor of Neurology and Neuroscience, Unit of Aerospace Medicine, Universidad Nacional, Bogota, Colombia ; Human Aerospace Laboratory, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Fidias E
authors.initials: FE
authors.lastname: Leon-Sarmiento
authors.forename: Gustavo
authors.initials: G
authors.lastname: Pradilla
authors.forename: Maria
authors.initials: M
authors.lastname: Del Rosario Zambrano